Monday, July 11, 2011

Is ignoring clinical evidence The Way Ahead for the RCGP and Prof Christopher Ward ?

One of the hot items of the last few years is revalidation of doctors. And supposedly the RCGP is leading the way.
With this in mind, it is astonishing that Prof Ward and the RCGP are leading the way in ignoring tons of clinical evidence that ME/CFS is a severely disabling physical disease. But as this comes from the RCGP, aka The Mrs Simon Wessely College, this actually doesn't come as a big surprise as the CBT psychiatrists have been ignoring clinical evidence for decades.

First, they have used the Oxford criteria, i.e. tired all the time, for decades in their so called ME research, which has no relevance to ME/CFS as one can see in the picture below. If a patient comes to the surgery, saying he is tired all the time, then you know straight away that he doesn't have a broken leg, just as you know straight away that he does not have ME, the abbreviation for Myalgic Encephalomyelitis.

Using the Oxford criteria is a fantastic Houdini trick but ignoring the fact that this illness comes in clusters, and as you know, any disease that comes in cluster outbreaks is an infectious disease, is another masterstroke of ignoring clinical evidence. We've had 50 to 60 outbreaks over the years, one was witnessed by Dr. Peter Snow, a GP in New Zealand, who noticed that people who fell ill with this disease, where young and fit patients who never came to see him in his single-handed GP practice. He also noticed that it took quite a while before these patients presented to him after falling ill in this outbreak, because they were so used to dealing with their own problems. They only started to come in, because of the severity of the problems and because the problems didn't go away.

For your information, Dr. Peter Snow, later not only became the president of the New Zealand College of General Practitioners, who had witnessed first-hand what a severely disabling neurological/infectious disease ME is but he also started to educate GPs and young doctors on the severity of this disease.

As we are into ignoring clinical evidence please let us ignore the fact that Australian researchers, after one of the ME/CFS outbreaks, were able to transfer the putative agent to monkeys. Further proof that this disease doesn't exist, wouldn't you say professor Ward. I almost started to like this ignoring clinical evidence principle, but my years of proper medical training interfered and said no-no, any proper doctor would say that this is further evidence that this is an infectious disease.

Another thing I would advise you to ignore is the fact that almost 5% of patients became ill with ME/CFS after a blood transfusion. So ME/CFS can be transferred via a blood transfusion, but again, let us not tell the general public and our doctors this because there is no purpose for doctors to know the facts about a disease. And we don't want another infectious disease out there on the loose, with no one doing anything about it, do we, Prof Ward, so I agree, it is better to ignore this fact as well and fob patients, with an infectious disease, off with psychotherapy to deny they have a severely disabling disease and blame the patient for not getting better.

Oh, and then there is the highly increased incidence of lymphomas in ME/ CFS, but no we don't want doctors to know this as well and use the thinking part of their brain because they might start to realise that ME/CFS is not all in the mind of the patient and that it is in fact caused by an oncogenic or cancer-causing virus.

The other thing I would ignore is the fact that the University of New Jersey has just shown that if you do a lumbar puncture, and analyse the proteins in the spinal fluid from patients with ME/CFS, chronic Lyme disease and healthy controls that you can easily distinguish the three groups.

I would also ignore the fact that Prof Newton has just shown that the lactic acid production in muscles of ME/CFS patients after exercise is 50 times higher than in healthy controls and that this doesn't improve with regular exercise.

I would definitely ignore the fact that the Harvard Medical School has shown that if you do a special form of EEGs, you can easily distinguish between healthy controls, depression and ME/CFS patients, because this fact directly contravenes the vested interests of the old boy network.

I would also advise to continue to ignore the fact that even Prof White, one of the main CBT fanatics has demonstrated that exercise causes immunological damage in ME/CFS. Did he use this in his Pace trial, obviously not, because using it would directly contravene the principle of ignoring clinical excellence.

Now let's have a look at the following remarks from Prof Ward, "It is important to remember that people with CFS want to be taken seriously, so show that you believe them." i.e. you don't but you want your patients to believe you do.

Now, you might say I am biased because I am writing this article, so I would suggest to ask the following three ladies, Allison, Annabel and Sofia, for advice. The problem is, you can not do that, as all three of these lovely ladies were bedridden with severe ME for many years, and then all three of them died of ME.

Yes you heard it right, their official cause of death was ME. But again, it is better to ignore this, so please continue to treat us with great hostility, ignore all clinical evidence that this is a severely disabling physical disease, which has nothing to do with being tired all the time, even though the CBT psychiatrist want you to believe it has, and then what happens, you fall ill with this disease yourself. The problem is, it is not only an infectious disease, it is also known that doctors, especially those who come into contact with lots of infections, for example, paediatricians and GPs, are at a much higher risk to develop this disease. When that happens, you will not only realise what a lot of psycho blah blah we have been reading about this disease in the BMJ and the Lancet, the official CBT fan club magazines, but also that we have wasted decades and millions of pounds to make sure that no one does any research to find the virus that causes this disease and to find a cure and proper treatment.

If you still think, just like Prof Ward wants you to believe that CBT and exercise are the two treatments for this disease, then just have a look at the recent reviews, including the CBT-is best Pace trial, which showed that CBT and exercise for ME/CFS do not cure anybody, and all the other recent reviews which showed that these two so-called treatments make us actually a lot worse. Which is what ME patients have been saying for decades, but who wants to listen to someone who is faking a severely disabling infectious disease, only to be subjected to ridicule, aggression and immense hostility by doctors and many others?

Prof Ward and the RCGP should have known all of this and more if they had studied some of the more than 4000 medical research articles which show that ME is a physical disease, with lots of muscle and immune abnormalities, but reading some of these articles would have required to turn on their computers to access this information which is readily available on the Internet and obviously on my site, and who wants to do that if he is into ignoring clinical excellence.

So, on behalf of the Dr. Speedy Network of Clinical Evidence, I would like to thank Prof Ward and the RCGP for ignoring shed loads of clinical evidence. Amazing, if you think that one is a professor and the other one calls itself a royal college which wants to lead the way in revalidation which supposedly is all about keeping up-to-date as a doctor by reading clinical evidence. And that in the 21st-century with the Internet and easily accessible clinical evidence available at the click of your mouse.

Prof Ward, if you and the RCGP would include your delightful article in your revalidation folder, the assessor could only come up with one conclusion and that is that both of you have miserably failed your revalidation and that you would have to do it all over again. When you rewrite your article, which has ignored all clinical evidence, then please use the above information. Maybe you could even include the exercise testing done by the Pacific fatigue laboratory, which easily showed the difference between healthy controls, lazy couch potatoes and ME/CFS patients who are desperate to get better, go back to the work we love and participate in all sorts of social events including my beloved sports.

"Plenty of people are still dying of diseases which other people do not believe." (Dr. M.N.C. Dukes).CBT and GET for ME: "There is no nonsense so gross that society will not, at some time, make a doctrine of it and defend it with every weapon of communal stupidity."

Robertson Davies

THE NICEGUIDELINES BLOG VERSUS THE NICEGUIDELINES

These are NOT the NICEGuidelines. This is "The NICEGUIDELINES BLOG." What are the differences:

The NICE Guidelines are biased publications based on the GOBSART (Good Old Boys Sitting Around a Table) approach.

This Blog however is not only evidence based but also uses critical reading to judge papers and articles. I also use common sense and listen to others. And finally I read both psychiatric and medical evidence and opinions from around the world to come to a conclusion.

I’m not sponsored by anybody or paid by whatever company as seems to be the norm with many psycho people who publish the same article almost on a weekly base.

So if you value an opinion, formed as a result of participating in many ME activities, for example being bed bound for years, you have come to the right BLOG. All these activities have allowed me to form an opinion as a Doctor and as a Patient. And that is important as the voice of the latter is discarded by many including NICE.

If you don’t read this blog, you will miss out on “accredited” medical education. If you do read it, you may actually become a doctor who doesn’t stop thinking or forgets to ask critical questions. Many good things, including satisfied patients are at your command.

So, if you arrived here for the straightforward GOBSART approach, I will disappoint you. If you are interested in forming your own opinion about ME, and other interesting things, read on!

About Dr. Speedy.

I am a Family Physician or GP as it is called in Australia or the UK. I am also an ME patient unfortunately. Bedbound that is. So at the moment I’m in private practice so to speak. I’ve got only one patient, ME, or is it me?

I graduated as a doctor a long time ago, and I am the founder and editor of The NICEGUIDELINES BLOG, an internet based ME BLOG that is devoted to critical reading and cheering you or ME up.

I have the following conflict of interest: I would like to get better and see that the wasting of public money on CBT (talk therapy for a neurological disease, really helpful) and other silly therapies for ME stops, and will be used in better ways.

My goal has always been to help, and if possible, cure patients. With this disease you will soon find out that many psychiatrists and psychologists are only in it to make money and get their name in the spotlight. And what happens to and with the patients is irrelevant.

I stand to benefit both mentally, physically and also financially if this silliness would stop, and I would get my health back, and I can go back to work and have a normal life again. Please evaluate my postings with this in mind! And remember, there are also (lots of) psychiatrists and psychologists who haven’t switched their brain off.